In Germany, the “public” healthcare operates unbelievably inefficiently. Instead of having mainly a centralized healthcare system composed of polyclinics with family doctors for general purpose visits and hospitals for specialized diagnosis and treatment, what they have is a decentralized system in which each doctor can create their own clinic and can decide whether to accept or not publicly insured patients. If they do, then when a publicly insured patient goes to a doctor, they have to scan their insurance card and the doctor gets paid by the public insurance based on the treatment, e.g. (making up the numbers) 30€ for a general diagnosis or 1000€ for an XRay.

Doctors absolutely have economic incentives to keep their clinics incredibly busy and to treat patients as fast as possible and to over diagnose them as much as possible (since the payment for a more complicated treatment is often much more juicy than that of simple stuff). Doctors in Germany are filthy rich, and most family doctors WON’T ACCEPT BOOKINGS and instead will treat patients based on order of arrival, which means in Germany people queue outdoors since 6am sick as fuck in winter waiting for doctor to open, because otherwise you won’t get into the doctor’s office. They don’t accept booked appointments because if the patient doesn’t come, they lose 30€.

Germany is an incredible shithole, I had the displeasure of living there for some years and my experiences with the medical system left me astonished and enraged.